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I learned I had cancer in March 2007: a Stage IV gastrointestinal cancer that was eventually determined to be gallbladder cancer. It is a deadly and demonic form of the disease, spreading and wreaking havoc with few symptoms until the cancer cells have taken control. As a result, in the past four and a half years I have undergone 65 cancer treatments, every three to four weeks, and my body has ingested and processed more than 500,000 milligrams of chemotherapy.

The cancer quieted down, but in April of this year it came roaring back with a scary diagnosis: inoperable liver cancer. My oncology team delivered five treatments of highly focused and intense radiation to the liver, and began another aggressive round of chemo.

With cancer once again threatening body and spirit, I knew what I needed to do. And that’s why I’m writing this from a serenely quiet campsite beside the Gilahina River in the wilds of Alaska.

With terminal illness there is no time to waste on anger, denial or self-pity. Cancer isn’t personal.

When my cancer was first diagnosed, it was a foregone conclusion by my doctors that I didn’t stand a chance, and words like “palliative” slipped clinically and coldly off tongues. “Summon your family” was the recommendation.

My family rallied — four daughters, including two who were away at college and sacrificed midterm exams, and my husband, who abandoned an entrepreneurial opportunity in Eastern Europe, taking more than 50 sleepless hours to arrive home.

The prognosis was numbing: less than three months to live.

I didn’t buy into it. And equally important, neither did my husband or daughters.

There was no time to waste. And no second chances. Finding the right doctor was the difference between life and imminent death. And fortunately for me and my family, I was enrolled in a health plan that gave me the freedom to choose my doctors.

We found Dr. George Fisher, head of clinical trials at Stanford Cancer Center. When he compassionately put his arm around my shoulder saying he couldn’t cure me but would do his best to treat me, I knew he was the doctor we’d been searching and praying for.

Under his care, I began my life as a chronic cancer patient, undergoing surgery and hours of chemotherapy and enrolling in clinical trials. Our hope was to reach remission and prolong it as long as possible.

Month after month, Dr. Fisher summed up the situation in my medical chart in notes like this one: “Patient continues to do well from the treatment of her incurable cancer and is aware of the high risk of recurrence and progression.” But that’s just what he wrote on paper. Each month, when Dr. Fisher came into the exam room, he reviewed the blood lab results and smiled. “This is remarkable,” he would say, and give me a hug.

Why one patient tolerates and responds to chemotherapy and another patient doesn’t is still a mystery.

For over four years, regardless of what is put into me, or taken out of me, my blood immunity markers are almost always in the normal range. My body can deal with strong chemotherapy, infection and inflammation. Maybe it’s because I spent the first 10 years of my life on an Oklahoma cotton farm, outdoors and mostly barefoot, absorbing bacteria and germs and strengthening my immune system. Maybe not.

Every milestone has been celebrated. After my first 20-week round of chemotherapy, I celebrated by sea kayaking in Fiji with my family. The first anniversary of surviving my terminal diagnosis, I celebrated with a handstand and a return to vigorous yoga and regular weight training. The day after each monthly infusion, I hike four miles into the Torrey Pines Reserve canyon listening to Elvis sing gospel.

I keep my emotional and mental immune system healthy by trying not to take things too personally or too seriously. Ecclesiastes is my single most important self-help source. The sage asks, in essence, what is the point of life? In the end he determines that wisdom suggests living well, keeping to the commandments of God and enjoying every bit of life we have the good fortune to spend.

Whenever my health or spirit takes a dive I flee to a national park, or camp alongside a creek, or hike in a canyon. Our national parks and forests have been called “sanctuaries for spirit.” Indeed, they are healing for me.

I have met other cancer patients with similar stories; some have been in treatment continuously for over eight years. We share many things in common. All of us are grateful for the gift of prolonged life. Our goal is to prolong remission or control tumor growth as long as possible in hopes of a cure.

I am humbled and at a loss to explain why my cancer has been kept under control when others have passed on, or are fighting for a few more weeks of life.

Dr. Fisher told me at our first appointment, more than four years ago, that he has seen even the most loving and positive people succumb to this disease, and even the most negative and sometimes unpleasant people become cured.

I think this was his way of telling me that I wasn’t responsible for the disease, and that I could not assume responsibility for the outcome either.